Provider Demographics
NPI:1235103714
Name:KUNKEL, ALAN R (DO)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:KUNKEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3542
Mailing Address - Fax:757-686-0230
Practice Address - Street 1:2203 E LITTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-4205
Practice Address - Country:US
Practice Address - Phone:757-583-2181
Practice Address - Fax:757-480-6482
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102050042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005645794Medicaid
VA541595397OtherCIGNA
VA541595397OtherTRICARE
VA541595397OtherAETNA
VA541595397OtherMEDATLANTIC SOLUTIONS
VA541595397OtherVIRGINIA HEALTH NETWORK
VA24438OtherSENTARA/OPTIMA
VA437340OtherANTHEM
VA437340OtherANTHEM
VA541595397OtherCIGNA